Medicare Program: Meeting of the Advisory Panel on Ambulatory Payment Classification (APC) Groups-March 1, 2, and 3, 2006, 76313-76315 [05-24290]
Download as PDF
<![CDATA[
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Notices
I Street, P.O. Box 17006, Fort Smith, AR
72917–7006
Medicare Provider #040055
Tampa General Hospital, 2 Columbia Drive,
Tampa, FL 33606
Medicare Provider #100128
Wesley Medical Center, 550 N. Hillside,
Wichita, KS 67214
Medicare Provider #170123
Effective Date—September 28, 2005
Advocate Illinois Masonic Medical Center,
836 W. Wellington Avenue, Chicago, IL
60657–5193
Medicare Provider #140182
East Texas Medical Center-Tyler, 1000 South
Beckham, Tyler, TX 75701
Medicare Provider #450083
Maimonides Medical Center, 4802 Tenth
Avenue, Brooklyn, NY 11219
Medicare Provider #330914
Mesa General Hospital, 515 North Mesa
Drive, Mesa, AZ 85201
Medicare Provider #030017
Opelousas General Health System, 539 E.
Prudhomme Street, P.O. Box 1389,
Opelousas, LA 70570
Medicare Provider #190017
Southern Ohio Medical Center, 1895 27th
Street, Portsmouth, OH 45662
Medicare Provider #360008
St. Joseph Hospital, 2901 Squalicum
Parkway, Bellingham, WA 98264
Medicare Provider #500030
St. Lukes Hospital, 801 Ostrum Street,
Bethlehem, PA 18015
Medicare Provider #390049
WakeMed Health and Hospitals, 3000 New
Bern Avenue, Raleigh, NC 27610
Medicare Provider #340069
Yale-New Haven Hospital, 20 York Street,
New Haven, CT 06504,
Medicare Provider #070022
[FR Doc. 05–24023 Filed 12–22–05; 8:45 am]
BILLING CODE 4120–01–U
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–1289–N]
Medicare Program: Meeting of the
Advisory Panel on Ambulatory
Payment Classification (APC)
Groups—March 1, 2, and 3, 2006
Centers for Medicare &
Medicaid Services (CMS), Department
of Health and Human Services (DHHS).
ACTION: Notice.
wwhite on PROD1PC61 with NOTICES
AGENCY:
SUMMARY: In accordance with section
10(a) of the Federal Advisory Committee
VerDate Aug<31>2005
16:55 Dec 22, 2005
Jkt 208001
Act (FACA) (5 U.S.C. Appendix 2), this
notice announces the first biannual
meeting of the Ambulatory Payment
Classification (APC) Panel (the Panel)
for 2006.
The purpose of the Panel is to review
the APC groups and their associated
weights and to advise the Secretary of
the Department of Health and Human
Services (HHS) and the Administrator of
the Centers for Medicare & Medicaid
Services (CMS) concerning the clinical
integrity of the APC groups and their
associated weights. The advice provided
by the Panel will be considered as CMS
prepares its annual updates of the
hospital Outpatient Prospective
Payment System (OPPS) through
rulemaking.
Meeting Dates: The first biannual
meeting for 2006 is scheduled for the
following dates and times:
• Wednesday, March 1, 2006, 1 p.m.
to 5 p.m. (e.s.t.).
• Thursday, March 2, 2006, 8 a.m. to
5 p.m. (e.s.t.).
• Friday, March 3, 2006, 8 a.m. to 12
noon (e.s.t.).
Deadlines:
Deadline for Hardcopy Comments/
Suggested Agenda Topics—
5 p.m. (e.s.t.), Wednesday, February 1,
2006.
Deadline for Hardcopy
Presentations—
5 p.m. (e.s.t.), Wednesday, February 1,
2006.
Deadline for Attendance
Registration—
5 p.m. (e.s.t.), Wednesday, February 8,
2006.
Deadline for Special
Accommodations—
5 p.m. (e.s.t.), Wednesday, February 8,
2006.
Submittal of Materials to the
Designated Federal Officer (DFO):
Because of staffing and resource
limitations, we cannot accept written
comments and presentations by FAX,
nor can we print written comments and
presentations received electronically for
dissemination at the meeting.
Only hardcopy comments and
presentations will be accepted for
placement in the meeting booklets. All
hardcopy presentations must be
accompanied by Form CMS–20017. The
form is now available through the CMS
Forms Web site. The URL for linking to
this form is (https://www.cms.hhs.gov/
forms/cms20017.pdf.)
We are also requiring electronic
versions of the written comments and
presentations (in addition to the
hardcopies), so we can send them
electronically to the Panel members for
their review before the meeting.
DATES:
PO 00000
Frm 00084
Fmt 4703
Sfmt 4703
76313
Consequently, you must send BOTH
electronic and hardcopy versions of
your presentations and written
comments by the prescribed deadlines.
(Electronic transmission must be sent to
the e-mail address below, and
hardcopies—accompanied by Form
CMS–20017—must be mailed to the
Designated Federal Officer [DFO], as
specified in the FOR FURTHER
INFORMATION CONTACT: section of this
notice.)
ADDRESSES: The meeting will be held in
the Multipurpose Room, 1st Floor, CMS
Central Office, 7500 Security Boulevard,
Baltimore, Maryland 21244–1850.
FOR FURTHER INFORMATION CONTACT: For
inquiries regarding the meeting; meeting
registration; and hardcopy submissions
of oral presentations, agenda items, and
comments, please contact the DFO:
Shirl Ackerman-Ross, DFO, CMS, CMM,
HAPG, DOC, 7500 Security Boulevard,
Mail Stop C4–05–17, Baltimore, MD
21244–1850. Phone: (410) 786–4474.
• E-mail Address for comments,
presentations, and registration requests
is APCPanel@cms.hhs.gov
• News media representatives must
contact our Public Affairs Office at (202)
690–6145.
Advisory Committees’ Information
Lines:
The CMS Advisory Committees’
Information Line is 1–877–449–5659
(toll free) and (410) 786–9379 (local).
Web Sites:
• For additional information on the
APC meeting agenda topics and updates
to the Panel’s activities, search our Web
site at: https://www.cms.hhs.gov/faca/
apc/default.asp.
• To obtain Charter copies, search our
Web site at https://www.cms.hhs.gov/
faca or e-mail the Panel DFO.
SUPPLEMENTARY INFORMATION:
I. Background
The Secretary is required by section
1833(t)(9)(A) of the Act, as amended and
redesignated by sections 201(h) and
202(a)(2) of the Medicare, Medicaid, and
SCHIP Balanced Budget Refinement Act
of 1999 (BBRA) (Pub. L. 106–113),
respectively, to establish and consult
with an expert, outside advisory panel
on Ambulatory Payment Classification
(APC) groups. The APC Panel (the
Panel), which was re-chartered by the
Secretary on November 1, 2004, meets
up to three times annually to review the
APC groups and to provide technical
advice to the Secretary and the
Administrator concerning the clinical
integrity of the groups and their
associated weights. All members must
have technical expertise that shall
enable them to participate fully in the
E:\FR\FM\23DEN1.SGM
23DEN1
76314
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Notices
• Evaluation of APC weights.
• Packaging devices and drug costs
into APCs: methodology, effect on
APCs, and need for reconfiguring APCs
based upon device and drug packaging.
• Removal of procedures from the
inpatient list for payment under the
OPPS.
• Use of single and multiple
procedure claims data.
• Packaging of HCPCS codes.
• Other technical issues concerning
APC structure.
The subject matter before the Panel
shall be limited to these and related
topics. Unrelated topics are not subjects
for discussion. Unrelated topics include,
but are not limited to, the conversion
factor, cost compression, pass-through
payments for medical devices and
drugs, and wage adjustments. These
subjects will not be addressed by the
Panel.
The Panel may use data collected or
developed by entities and organizations,
other than DHHS and CMS, in
conducting its review.
II. Agenda
wwhite on PROD1PC61 with NOTICES
work of the Panel. Such expertise
encompasses hospital payment systems,
hospital medical-care delivery systems,
outpatient payment requirements, APCs,
Current Procedural Terminology (CPT)
codes, and the use and payment of
drugs and medical devices in the
outpatient setting, as well as other forms
of relevant expertise. However, it is not
necessary that any one member be an
expert in all of the areas listed above.
All members shall have a minimum of
5 years experience in their areas of
expertise, and they must be currently
employed full-time in their areas of
expertise. For purposes of this Panel,
consultants or independent contractors
are not considered to be full-time
employees.
We will consider the technical advice
provided by the Panel as we prepare the
proposed changes to the OPPS for the
next calendar year.
The Panel may consist of a Chair and
up to 15 representatives who are fulltime employees (not consultants) of
Medicare providers, which are subject
to the OPPS.
The Administrator selects the Panel
membership based upon either selfnominations or nominations submitted
by providers or interested organizations.
The Panel presently consists of the
following members and a Chair:
• Edith Hambrick, M.D., J.D., Chair.
• Marilyn Bedell, M.S., R.N., O.C.N.
• Gloryanne Bryant, B.S., R.H.I.A.,
R.H.I.T., C.C.S.
• Albert Brooks Einstein, Jr., M.D.
• Hazel Kimmel, R.N., C.C.S., C.P.C.
• Sandra J. Metzler, M.B.A., R.H.I.A.,
C.P.H.Q.
• Thomas M. Munger, M.D., F.A.C.C.
• Frank G. Opelka, M.D., F.A.C.S.
• Louis Potters, M.D., F.A.C.R.
• James V. Rawson, M.D.
• Lou Ann Schraffenberger, M.B.A.,
R.H.I.A., C.C.S.–P.
• Judie S. Snipes, R.N., M.B.A.,
F.A.C.H.E.
• Lynn R. Tomascik, R.N., M.S.N.,
C.N.A.A.
• Timothy Gene Tyler, Pharm.D.
• Kim Allan Williams, M.D., F.A.C.C.,
F.A.B.C.
• Robert Matthew Zwolak, M.D.,
Ph.D., F.A.C.S.
V. Presenter and Presentation Criteria
The agenda for the March 2006
meeting will provide for discussion and
comment on the following topics as
designated in the Panel’s Charter:
• Reconfiguration of APCs (for
example, splitting of APCs, moving
Healthcare Common Procedure Coding
System (HCPCS) codes from one APC to
another and moving HCPCS codes from
new technology APCs to clinical APCs).
The additional criteria below must be
supplied to the DFO by the date
specified in the DATES section of this
notice (along with hardcopies of
presentations).
• Required personal information
regarding presenter(s):
+ Name of presenter(s);
+ Title(s);
+ Organizational affiliation;
VerDate Aug<31>2005
16:55 Dec 22, 2005
Jkt 208001
III. Written Comments and Suggested
Agenda Topics
Hardcopy written comments and
suggested agenda topics should be sent
to the DFO. Such items must be
received by the date and time specified
in the DATES section of this notice.
Additionally, the written comments
and suggested agenda topics must fall
within the subject categories outlined in
the Panel’s Charter listed in the Agenda
section of this notice.
IV. Oral Presentations
Individuals or organizations wishing
to make 5-minute oral presentations
must contact the DFO. The DFO must
receive hardcopy presentations by the
date and time specified in the DATES
section of this notice in order to be
scheduled.
The number of oral presentations may
be limited by the time available. Oral
presentations should not exceed 5
minutes in length.
The Chair may further limit time
allowed for presentations due to the
number of oral presentations, if
necessary.
PO 00000
Frm 00085
Fmt 4703
Sfmt 4703
+ Address;
+ E-mail address, and
+ Telephone number(s).
• All presentations must contain, at a
minimum, the following supporting
information and data:
+ Financial relationship(s) of
presenter(s), if any, with any company
whose products, services, or procedures
that are under consideration;
+ Physicians’ CPTs involved;
+ APC(s) affected;
+ Description of the issue(s);
+ Clinical description of the service
under discussion (with comparison to
other services within the APC);
+ Recommendations and rationale for
change;
+ Expected outcome of change; and
+ Potential consequences of not
making the change(s).
Note: All presenters must also submit Form
CMS–20017.
VI. Oral Comments
In addition to formal oral
presentations, there will be opportunity
during the meeting for public oral
comments, which will be limited to 1
minute for each individual and a total
of 5 minutes per organization.
VII. Meeting Attendance
The meeting is open to the public;
however, attendance is limited to space
available. Attendance will be
determined on a first-come, first-served
basis.
Persons wishing to attend this
meeting, which is located on Federal
property, must e-mail the Panel DFO to
register by the date and time specified
in the DATES section of this notice. A
confirmation will be sent to the
requester(s) via return e-mail.
The following information must be emailed or telephoned to the DFO by the
date and time above:
• Name(s) of attendee(s),
• Title(s),
• Organization,
• E-mail address(es), and
• Telephone number(s).
VIII. Security, Building, and Parking
Guidelines
Persons attending the meeting must
present photographic identification to
the Federal Protective Service or Guard
Service personnel before they will be
allowed to enter the building.
Security measures will include
inspection of vehicles, inside and out, at
the entrance to the grounds. In addition,
all persons entering the building must
pass through a metal detector. All items
brought to CMS, including personal
items such as desktops, cell phones,
E:\FR\FM\23DEN1.SGM
23DEN1
Federal Register / Vol. 70, No. 246 / Friday, December 23, 2005 / Notices
palm pilots, etc., are subject to physical
inspection.
Individuals who are not registered in
advance will not be permitted to enter
the building and will be unable to
attend the meeting. (Note: Presenters
must also be registered for attendance at
the meeting.) The public may enter the
building 30–45 minutes before when the
meeting convenes each day. (The
meeting convenes at the date and time
specified in the DATES section of this
notice.)
All visitors must be escorted in areas
other than the lower and first-floor
levels in the Central Building.
Parking permits and instructions are
issued upon arrival by the guards at the
main entrance.
IX. Special Accommodations
Individuals requiring sign-language
interpretation or other special
accommodations must send a request
for these services to the DFO by the date
and time specified in the DATES section
of this notice.
Authority: Section 1833(t)(9) of the Act (42
U.S.C. 13951(t)). The Panel is governed by
the provisions of Pub. L. 92–463, as amended
(5 U.S.C. Appendix 2).
(Catalog of Federal Domestic Assistance
Program No. 93.773, Medicare-Hospital
Insurance; and Program No. 93.774,
Medicare-Supplementary Medical Insurance
Program)
Dated: November 10, 2005.
Mark B. McClellan,
Administrator, Centers for Medicare &
Medicaid Services.
[FR Doc. 05–24290 Filed 12–22–05; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[CMS–1329–N]
Medicare Program; Town Hall Meeting
on the Fiscal Year 2007 Applications
for New Medical Services and
Technologies Add-On Payments Under
the Hospital Inpatient Prospective
Payment System Scheduled for
February 16, 2006
Centers for Medicare &
Medicaid Services (CMS), HHS.
ACTION: Notice of meeting.
wwhite on PROD1PC61 with NOTICES
AGENCY:
SUPPLEMENTARY INFORMATION:
This notice, in accordance
with section 1886(d)(5)(K)(viii) of the
Social Security Act (the Act), announces
a Town Hall meeting to discuss fiscal
year (FY) 2007 applications for add-on
payments for new medical services and
SUMMARY:
VerDate Aug<31>2005
16:55 Dec 22, 2005
Jkt 208001
technologies under the hospital
inpatient prospective payment system
(IPPS). Interested parties are invited to
this meeting to present their individual
comments, recommendations, and data
regarding whether the FY 2007 new
medical services and technologies
applications meet the substantial
clinical improvement criteria.
DATES: Meeting Date: The Town Hall
meeting announced in this notice will
be held on Thursday, February 16, 2006
at 9 a.m., and check-in will begin at 8:30
a.m. EST.
Registration Deadline for Presenters:
All presenters, whether attending in
person or by phone, must register and
submit their agenda item(s) by February
8, 2006.
Registration Deadline for All Other
Participants: All other participants must
register by February 13, 2006.
Comment Deadline: Written
comments for discussion at the meeting
must be received by February 8, 2006.
All other written comments for
consideration before publication of the
hospital IPPS proposed rule must be
received by March 15, 2006.
ADDRESSES: The Town Hall meeting will
be held in the Auditorium in the central
building of the Centers for Medicare &
Medicaid Services, 7500 Security
Boulevard, Baltimore, MD 21244–1850.
Agenda Item(s) or Written Comments:
Agenda items and written comments
regarding whether a FY 2007
application meets the substantial
clinical improvement criterion may be
sent by mail, fax, or electronically.
Agenda items must be received by
February 8, 2006. We will accept
written questions or other statements,
not to exceed three single-spaced, typed
pages that are received by March 15,
2006. Send written comments,
questions, or other statements to—
Division of Acute Care, Mail stop C4–
07–05, Centers for Medicare & Medicaid
Services, 7500 Security Boulevard,
Baltimore, Maryland 21244–1850.
Attention: Meredith Walz or Michael
Treitel.
Fax: (410) 786–0169.
Email: newtech@cms.hhs.gov.
FOR FURTHER INFORMATION CONTACT:
Meredith Walz, (410) 786–9421,
meredith.walz@cms.hhs.gov. Michael
Treitel, (410) 786–4552,
michael.treitel@cms.hhs.gov.
I. Background
Sections 1886(d)(5)(K) and (L) of the
Social Security Act (the Act) require the
Secretary to establish a process of
identifying and ensuring adequate
PO 00000
Frm 00086
Fmt 4703
Sfmt 4703
76315
payments for new medical services and
technologies under Medicare.
Effective for discharges beginning on
or after October 1, 2001, section
1886(d)(5)(K)(i) of the Act required the
Secretary to establish (after notice and
opportunity for public comment) a
mechanism to recognize the costs of
new services and technologies under the
inpatient hospital prospective payment
system (IPPS). In addition, section
1886(d)(5)(K)(vi) of the Act specifies
that a medical service or technology will
be considered ‘‘new’’ if it meets criteria
established by the Secretary (after notice
and opportunity for public comment).
(See the FY 2002 proposed rule (66 FR
22693, May 4, 2001) and the FY 2002
final rule (66 FR 46912, September 7,
2001) for a more detailed discussion.) In
addition, we have further discussed our
application of the newness criteria in
the hospital IPPS proposed and final
rules for FYs 2003, 2004, 2005, and
2006. (See 67 FR 31427, May 9, 2002;
67 FR 50009, August 1, 2002; 68 FR
27184, May 19, 2003; 68 FR 45385,
August 1, 2003; 69 FR 28236, May 18,
2004; 69 FR 49000, August 11, 2004; 70
FR 23353, May 5, 2005; and 70 FR
47341, August 12, 2005 respectively).
In the September 7, 2001 final rule (66
FR 46914), we noted that we evaluate a
request for special payment for a new
medical service or technology against
the following criteria in order to
determine if the new technology meets
the substantial clinical improvement
requirement:
• The device offers a treatment option
for a patient population unresponsive
to, or ineligible for, currently available
treatments.
• The device offers the ability to
diagnose a medical condition in a
patient population where that medical
condition is currently undetectable or
offers the ability to diagnose a medical
condition earlier in a patient population
than allowed by currently available
methods. There must also be evidence
that use of the device to make a
diagnosis affects the management of the
patient.
• Use of the device significantly
improves clinical outcomes for a patient
population as compared to currently
available treatments. Some examples of
outcomes that are frequently evaluated
in studies of medical devices are the
following:
++ Reduced mortality rate with use of
the device.
++ Reduced rate of device-related
complications.
++ Decreased rate of subsequent
diagnostic or therapeutic interventions
(for example, due to reduced rate of
recurrence of the disease process).
E:\FR\FM\23DEN1.SGM
23DEN1
]]>Agencies
[Federal Register Volume 70, Number 246 (Friday, December 23, 2005)]
[Notices]
[Pages 76313-76315]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-24290]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[CMS-1289-N]
Medicare Program: Meeting of the Advisory Panel on Ambulatory
Payment Classification (APC) Groups--March 1, 2, and 3, 2006
AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of
Health and Human Services (DHHS).
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: In accordance with section 10(a) of the Federal Advisory
Committee Act (FACA) (5 U.S.C. Appendix 2), this notice announces the
first biannual meeting of the Ambulatory Payment Classification (APC)
Panel (the Panel) for 2006.
The purpose of the Panel is to review the APC groups and their
associated weights and to advise the Secretary of the Department of
Health and Human Services (HHS) and the Administrator of the Centers
for Medicare & Medicaid Services (CMS) concerning the clinical
integrity of the APC groups and their associated weights. The advice
provided by the Panel will be considered as CMS prepares its annual
updates of the hospital Outpatient Prospective Payment System (OPPS)
through rulemaking.
DATES: Meeting Dates: The first biannual meeting for 2006 is scheduled
for the following dates and times:
Wednesday, March 1, 2006, 1 p.m. to 5 p.m. (e.s.t.).
Thursday, March 2, 2006, 8 a.m. to 5 p.m. (e.s.t.).
Friday, March 3, 2006, 8 a.m. to 12 noon (e.s.t.).
Deadlines:
Deadline for Hardcopy Comments/Suggested Agenda Topics--
5 p.m. (e.s.t.), Wednesday, February 1, 2006.
Deadline for Hardcopy Presentations--
5 p.m. (e.s.t.), Wednesday, February 1, 2006.
Deadline for Attendance Registration--
5 p.m. (e.s.t.), Wednesday, February 8, 2006.
Deadline for Special Accommodations--
5 p.m. (e.s.t.), Wednesday, February 8, 2006.
Submittal of Materials to the Designated Federal Officer (DFO):
Because of staffing and resource limitations, we cannot accept
written comments and presentations by FAX, nor can we print written
comments and presentations received electronically for dissemination at
the meeting.
Only hardcopy comments and presentations will be accepted for
placement in the meeting booklets. All hardcopy presentations must be
accompanied by Form CMS-20017. The form is now available through the
CMS Forms Web site. The URL for linking to this form is (https://
www.cms.hhs.gov/forms/cms20017.pdf.)
We are also requiring electronic versions of the written comments
and presentations (in addition to the hardcopies), so we can send them
electronically to the Panel members for their review before the
meeting.
Consequently, you must send BOTH electronic and hardcopy versions
of your presentations and written comments by the prescribed deadlines.
(Electronic transmission must be sent to the e-mail address below, and
hardcopies--accompanied by Form CMS-20017--must be mailed to the
Designated Federal Officer [DFO], as specified in the FOR FURTHER
INFORMATION CONTACT: section of this notice.)
ADDRESSES: The meeting will be held in the Multipurpose Room, 1st
Floor, CMS Central Office, 7500 Security Boulevard, Baltimore, Maryland
21244-1850.
FOR FURTHER INFORMATION CONTACT: For inquiries regarding the meeting;
meeting registration; and hardcopy submissions of oral presentations,
agenda items, and comments, please contact the DFO: Shirl Ackerman-
Ross, DFO, CMS, CMM, HAPG, DOC, 7500 Security Boulevard, Mail Stop C4-
05-17, Baltimore, MD 21244-1850. Phone: (410) 786-4474.
E-mail Address for comments, presentations, and
registration requests is APCPanel@cms.hhs.gov
News media representatives must contact our Public Affairs
Office at (202) 690-6145.
Advisory Committees' Information Lines:
The CMS Advisory Committees' Information Line is 1-877-449-5659
(toll free) and (410) 786-9379 (local).
Web Sites:
For additional information on the APC meeting agenda
topics and updates to the Panel's activities, search our Web site at:
https://www.cms.hhs.gov/faca/apc/default.asp.
To obtain Charter copies, search our Web site at https://
www.cms.hhs.gov/faca or e-mail the Panel DFO.
SUPPLEMENTARY INFORMATION:
I. Background
The Secretary is required by section 1833(t)(9)(A) of the Act, as
amended and redesignated by sections 201(h) and 202(a)(2) of the
Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999
(BBRA) (Pub. L. 106-113), respectively, to establish and consult with
an expert, outside advisory panel on Ambulatory Payment Classification
(APC) groups. The APC Panel (the Panel), which was re-chartered by the
Secretary on November 1, 2004, meets up to three times annually to
review the APC groups and to provide technical advice to the Secretary
and the Administrator concerning the clinical integrity of the groups
and their associated weights. All members must have technical expertise
that shall enable them to participate fully in the
[[Page 76314]]
work of the Panel. Such expertise encompasses hospital payment systems,
hospital medical-care delivery systems, outpatient payment
requirements, APCs, Current Procedural Terminology (CPT) codes, and the
use and payment of drugs and medical devices in the outpatient setting,
as well as other forms of relevant expertise. However, it is not
necessary that any one member be an expert in all of the areas listed
above. All members shall have a minimum of 5 years experience in their
areas of expertise, and they must be currently employed full-time in
their areas of expertise. For purposes of this Panel, consultants or
independent contractors are not considered to be full-time employees.
We will consider the technical advice provided by the Panel as we
prepare the proposed changes to the OPPS for the next calendar year.
The Panel may consist of a Chair and up to 15 representatives who
are full-time employees (not consultants) of Medicare providers, which
are subject to the OPPS.
The Administrator selects the Panel membership based upon either
self-nominations or nominations submitted by providers or interested
organizations. The Panel presently consists of the following members
and a Chair:
Edith Hambrick, M.D., J.D., Chair.
Marilyn Bedell, M.S., R.N., O.C.N.
Gloryanne Bryant, B.S., R.H.I.A., R.H.I.T., C.C.S.
Albert Brooks Einstein, Jr., M.D.
Hazel Kimmel, R.N., C.C.S., C.P.C.
Sandra J. Metzler, M.B.A., R.H.I.A., C.P.H.Q.
Thomas M. Munger, M.D., F.A.C.C.
Frank G. Opelka, M.D., F.A.C.S.
Louis Potters, M.D., F.A.C.R.
James V. Rawson, M.D.
Lou Ann Schraffenberger, M.B.A., R.H.I.A., C.C.S.-P.
Judie S. Snipes, R.N., M.B.A., F.A.C.H.E.
Lynn R. Tomascik, R.N., M.S.N., C.N.A.A.
Timothy Gene Tyler, Pharm.D.
Kim Allan Williams, M.D., F.A.C.C., F.A.B.C.
Robert Matthew Zwolak, M.D., Ph.D., F.A.C.S.
II. Agenda
The agenda for the March 2006 meeting will provide for discussion
and comment on the following topics as designated in the Panel's
Charter:
Reconfiguration of APCs (for example, splitting of APCs,
moving Healthcare Common Procedure Coding System (HCPCS) codes from one
APC to another and moving HCPCS codes from new technology APCs to
clinical APCs).
Evaluation of APC weights.
Packaging devices and drug costs into APCs: methodology,
effect on APCs, and need for reconfiguring APCs based upon device and
drug packaging.
Removal of procedures from the inpatient list for payment
under the OPPS.
Use of single and multiple procedure claims data.
Packaging of HCPCS codes.
Other technical issues concerning APC structure.
The subject matter before the Panel shall be limited to these and
related topics. Unrelated topics are not subjects for discussion.
Unrelated topics include, but are not limited to, the conversion
factor, cost compression, pass-through payments for medical devices and
drugs, and wage adjustments. These subjects will not be addressed by
the Panel.
The Panel may use data collected or developed by entities and
organizations, other than DHHS and CMS, in conducting its review.
III. Written Comments and Suggested Agenda Topics
Hardcopy written comments and suggested agenda topics should be
sent to the DFO. Such items must be received by the date and time
specified in the DATES section of this notice.
Additionally, the written comments and suggested agenda topics must
fall within the subject categories outlined in the Panel's Charter
listed in the Agenda section of this notice.
IV. Oral Presentations
Individuals or organizations wishing to make 5-minute oral
presentations must contact the DFO. The DFO must receive hardcopy
presentations by the date and time specified in the DATES section of
this notice in order to be scheduled.
The number of oral presentations may be limited by the time
available. Oral presentations should not exceed 5 minutes in length.
The Chair may further limit time allowed for presentations due to
the number of oral presentations, if necessary.
V. Presenter and Presentation Criteria
The additional criteria below must be supplied to the DFO by the
date specified in the DATES section of this notice (along with
hardcopies of presentations).
Required personal information regarding presenter(s):
+ Name of presenter(s);
+ Title(s);
+ Organizational affiliation;
+ Address;
+ E-mail address, and
+ Telephone number(s).
All presentations must contain, at a minimum, the
following supporting information and data:
+ Financial relationship(s) of presenter(s), if any, with any
company whose products, services, or procedures that are under
consideration;
+ Physicians' CPTs involved;
+ APC(s) affected;
+ Description of the issue(s);
+ Clinical description of the service under discussion (with
comparison to other services within the APC);
+ Recommendations and rationale for change;
+ Expected outcome of change; and
+ Potential consequences of not making the change(s).
Note: All presenters must also submit Form CMS-20017.
VI. Oral Comments
In addition to formal oral presentations, there will be opportunity
during the meeting for public oral comments, which will be limited to 1
minute for each individual and a total of 5 minutes per organization.
VII. Meeting Attendance
The meeting is open to the public; however, attendance is limited
to space available. Attendance will be determined on a first-come,
first-served basis.
Persons wishing to attend this meeting, which is located on Federal
property, must e-mail the Panel DFO to register by the date and time
specified in the DATES section of this notice. A confirmation will be
sent to the requester(s) via return e-mail.
The following information must be e-mailed or telephoned to the DFO
by the date and time above:
Name(s) of attendee(s),
Title(s),
Organization,
E-mail address(es), and
Telephone number(s).
VIII. Security, Building, and Parking Guidelines
Persons attending the meeting must present photographic
identification to the Federal Protective Service or Guard Service
personnel before they will be allowed to enter the building.
Security measures will include inspection of vehicles, inside and
out, at the entrance to the grounds. In addition, all persons entering
the building must pass through a metal detector. All items brought to
CMS, including personal items such as desktops, cell phones,
[[Page 76315]]
palm pilots, etc., are subject to physical inspection.
Individuals who are not registered in advance will not be permitted
to enter the building and will be unable to attend the meeting. (Note:
Presenters must also be registered for attendance at the meeting.) The
public may enter the building 30-45 minutes before when the meeting
convenes each day. (The meeting convenes at the date and time specified
in the DATES section of this notice.)
All visitors must be escorted in areas other than the lower and
first-floor levels in the Central Building.
Parking permits and instructions are issued upon arrival by the
guards at the main entrance.
IX. Special Accommodations
Individuals requiring sign-language interpretation or other special
accommodations must send a request for these services to the DFO by the
date and time specified in the DATES section of this notice.
Authority: Section 1833(t)(9) of the Act (42 U.S.C. 13951(t)).
The Panel is governed by the provisions of Pub. L. 92-463, as
amended (5 U.S.C. Appendix 2).
(Catalog of Federal Domestic Assistance Program No. 93.773,
Medicare-Hospital Insurance; and Program No. 93.774, Medicare-
Supplementary Medical Insurance Program)
Dated: November 10, 2005.
Mark B. McClellan,
Administrator, Centers for Medicare & Medicaid Services.
[FR Doc. 05-24290 Filed 12-22-05; 8:45 am]
BILLING CODE 4120-01-P
